Obama Gets 12 Stitches in Lip After Basketball Mishap

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http://www.bloomberg.com/news/2010-...ng-elbowed-in-lip-during-basketball-game.html

President Barack Obama got 12 stitches in his lip after being injured during a basketball game, spokesman Robert Gibbs said.

"After being inadvertently hit with an opposing player's elbow in the lip while playing basketball with friends and family, the president received 12 stitches today administered by the White House medical unit," Gibbs said in a statement. The president played basketball for about 90 minutes at a gym at Fort McNair in Washington.

Obama played basketball regularly during the 2008 presidential campaign and had a basketball court installed on the South Lawn of the White House. In addition to playing at Fort McNair, he plays at other local sites, including the Interior Department.

Today, the president played with family members and friends in town for Thanksgiving, as well as with his personal aide, Reggie Love, a former college basketball player at Duke University.

Gibbs didn't disclose who injured the president.

In treating the president, doctors used a smaller filament which increases the number of stitches but makes a tighter stitch, resulting in "a smaller scar," according to an e-mailed White House statement.

Obama received a local anesthetic while getting the stitches, the statement said.

To contact the reporter on this story: Roger Runningen in Washington at [email protected]
 

dineshchaturvedi

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I heard that too, 12 is bit too much. The maximum I have had is 5 five times on my head and it was not good feeling and 12 is twice as much plus 2. Hope for his speedy recovery.
 

hit&run

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12 stitches means very very fine thread used and extremely cosmetic point of view procedure.
 

RAM

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Most likely the wound will be a large through/through laceration,sutured by fine 3-0 vicryl or prolene 5-0 stitches.




Dr. Tony Youn, a board certified plastic surgeon in Detroit, Michigan, said it's the most common injury call he gets from the emergency room - someone gets smacked in the face and ends up with a cut lip. It usually happens when a tooth punctures the lip.
"The lips are very sensitive to trauma and swell up quickly, more than any parts of the body," he said. "When you get popped in the jaw, you don't get a fat chin, you get a fat lip. The lips are so reactive."
The lips are made of mucosa, the moist tissue that makes them fragile (especially to a flying elbow).
White House aides told CNN that Obama was given a local anesthetic while receiving the stitches and doctors used a smaller suture thread, or filament. That increases the number of stitches needed to patch up the tear, but it makes a tighter stitch so that the president's scar on his lower lip should be smaller.
Dr. Laurie Casas, a clinical associate professor of surgery at the University of Chicago Pritzer School of Medicine, said that 12 stitches aren't a lot, since each stitch can be as small as two to three millimeters.
A deeper injury penetrating the muscle layer in the lip would require a more complicated stitch called a buried stitch, she added. Depending on whether the stitches are on the outer layer of the lip or deeper into the muscle, the stitches could be left in from five to 14 days. Stitches in the muscle layer of the lip would typically dissolve.
The key for the plastic surgeon is that "you reconstruct the border of the lips called the vermillion border," Casas said. That needs to be lined up first, so you don't distort that border."
If they're not lined perfectly, you could see a "cosmetic deformity," said Dr. Marc Yune, a certified facial plastic surgeon in the greater Atlanta area.


Obama can expect swelling and bruising for a couple weeks. And he, like many others with a severe lip lacerations may be told to stay on a liquid diet or avoid crunchy foods, to prevent a potato chip from slicing through the wound.
 
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hit&run

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^ thanks doc.
Lip cuts are mostly mesh with tooth prints, not in a straight line. So number of suture can increase manifold.

Vicryl might have been used if the wound is deeper i.e injury to orbicularis oris, then mucous membrane closed with absorbable suture line.

Instead of prolene the Nylon sutures would have been the choice of sutures for closing layer for me, since the area is going to be moist all the time and it has to soft for chewing speaking etc (Prolene will become soft after one-two days though). Circle X2 11 mm nylon needle will do the trick and serve the cosmetic cause. I think in both cases a less deeper buy mesh or deeper cut justifies 12 sutures.

I was wondering, to correct myself why would you stress on cosmetic point of view if the laceration is inside..lol.

Nylon is a better choice of sutures for oral cavity and gingival tissue.
Astract
Silk, cotton, and nylon suture materials were implanted in the tunica propria of the gingiva in seven adult rhesus monkeys. The histologie study of twenty-four biopsy specimens indicated that there was neither an increase in the vascular permeability nor a leukocytic margination and migration into the tissues adjacent to the suture materials. However, there was a variable histiocytic reaction, with multinucleated cell formation. This reaction was quite intense with cotton, less intense with silk, and practically absent with nylon. The greater cellular response to cotton was probably due to its more active capacity for modifying the internal biologic medium of the gingvia.
 

plugwater

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what was secret service doing ? :D
Isn't their job to protect the president from all threats (foreign and domestic)... lol
 

The Messiah

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serves him right for playing shitty game like basketball.
 

Virendra

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hey .. !! don't you say anything about basketball, my favorite :)
 

RAM

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^ thanks doc.
Lip cuts are mostly mesh with tooth prints, not in a straight line. So number of suture can increase manifold.

Vicryl might have been used if the wound is deeper i.e injury to orbicularis oris, then mucous membrane closed with absorbable suture line.

Instead of prolene the Nylon sutures would have been the choice of sutures for closing layer for me, since the area is going to be moist all the time and it has to soft for chewing speaking etc (Prolene will become soft after one-two days though). Circle X2 11 mm nylon needle will do the trick and serve the cosmetic cause. I think in both cases a less deeper buy mesh or deeper cut justifies 12 sutures.

I was wondering, to correct myself why would you stress on cosmetic point of view if the laceration is inside..lol.

Nylon is a better choice of sutures for oral cavity and gingival tissue.
@ Hit/run






Dear Doc,

From the News description and picture it looks Look like as a classic case of a through and through laceration involving Lower labium skin (including vermillion border), Intraoral mucosa ,deeper layers+Orbiclaris oris . Extra orally 5-0 or 6-0 prolene sutures are used for skin closure.Thats where cosmetic angle gains significance.

An Example Given below(though this look like and resulted froma sharp instrument).










Intra oral wound approximation is normally carried out by Vicryl which is the current choice to approximate deeper layers.And the usage of nylon sutures Intra orally(in superficial layers) is also been changed to Vicryl as this will remove the hassle of suture removal at a later stage in post op cases ( as this is a resorbable material).Usage of Nylon is restricted nowa days to Intra oral surgical defects approximation or in flaps and grafts mostly pertaining to Head and Neck Oncology or in Orthognathic cases.Thank you.
 
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